Pd F 5180 Reinvestment Request

OMB No. 1535-0069

PD F 5180 E
Department of the Treasury
Bureau of the Public Debt
(Revised June 2008)

Legacy Treasury Direct

®

REINVESTMENT REQUEST

www.treasurydirect.gov
1-800-722-2678

SEE INSTRUCTIONS - TYPE OR PRINT IN INK ONLY - NO ALTERATIONS OR CORRECTIONS

1. Legacy Treasury Direct ACCOUNT INFORMATION You will find this information on your Statement of Account.

FOR DEPARTMENT USE

Legacy Treasury Direct ACCOUNT NUMBER
DOCUMENT AUTHORITY

ACCOUNT NAME

APPROVED BY

DATE APPROVED

Have You Tried Reinvest Direct ® ? It’s Easy!
To make a full reinvestment of your maturing securities, try our
phone (1-800-722-2678) or web services (www.treasurydirect.gov).

CUSIP

2. SCHEDULING

Reinvesting a BILL? Choose left column. Reinvesting a NOTE? Choose right column.

BILL REINVESTMENT
A.

REINVEST

FOR

13 WEEKS

NOTE REINVESTMENT

OR
TIMES
(FROM 1-8)

A.

REINVEST

$

$

YEARS

FOR
AMOUNT

AMOUNT

FOR

26 WEEKS

TIMES
(FROM 1-4)

B.

REINVEST THE SUB-ACCOUNTS SHOWN BELOW.
(Use this option ONLY when specifying SUB-ACCOUNTS.)

FOR

52 WEEKS

TIMES
(FROM 1-2)

B.

REINVEST THE SUB-ACCOUNTS SHOWN BELOW.

SUBACCOUNT

(Use this option ONLY when specifying SUB-ACCOUNTS.)

SUBACCOUNT

TERM
NUMBER OF
(13, 26, or 52) REINVESTMENTS

AMOUNT

AMOUNT

TERM

$

YEARS

$

YEARS

$

WEEKS

$

YEARS

$

WEEKS

$

YEARS

$

WEEKS
If the term you
have chosen is . . .

Then you may
schedule up to . . .

13 WEEKS

8 REINVESTMENTS

26 WEEKS

4 REINVESTMENTS

52 WEEKS

2 REINVESTMENTS

SPECIAL NOTICE (for NOTES only):
As long as the reinvestment option you choose is issued on or within
five calendar days of your security’s maturity date, we can reinvest your
funds with no problem. We simply place your money in a non-interest
bearing account until the new security’s issue date. More than a fiveday delay? We refund your money when your current security matures.

3. CANCELING
A.

ALL REINVESTMENTS.

B.

REINVESTMENTS ONLY FOR THE SUB-ACCOUNTS SHOWN HERE:

4. AUTHORIZATION
I submit this request pursuant to the provisions of Department of the Treasury Circulars, Public Debt Series Nos. 2-86 (31 CFR Part 357) and 1-93 (31 CFR Part 356), and
the applicable offering announcement. Under penalties of perjury, I further certify that all other information provided on this form is true, correct and complete.

Signature(s)

Title (if appropriate)

Date

Telephone

SEE INSTRUCTIONS FOR PRIVACY ACT AND PAPERWORK REDUCTION ACT NOTICE

RESET

(OVER)

PD F 5180
Department of the Treasury
Bureau of the Public Debt
(Revised June 2008)

Legacy Treasury Direct

®

INSTRUCTIONS FOR COMPLETING
A REINVESTMENT REQUEST

www.treasurydirect.gov
1-800-722-2678

PURPOSE
You may use this form to:
• schedule the reinvestment of either one Treasury bill or one note at maturity,
• cancel a reinvestment request, or
• change a reinvestment that was previously requested.
IMPORTANT NOTICES
• You must submit a separate form for each loan (CUSIP).
• Unless all the required information is provided legibly, there may be a delay in processing your request. To avoid delays, read the
instructions carefully and print clearly in ink only. Where spaces are provided, enter only one number in each space.
• REINVESTMENT REQUESTS WILL NOT BE ACCEPTED WITH ALTERATIONS OR CORRECTIONS.
• This form must be signed. Only original signatures and forms will be accepted (stamped signatures are not acceptable).
1. Legacy Treasury Direct ACCOUNT INFORMATION

You will find this information on your Statement of Account.

Legacy Treasury Direct ACCOUNT NUMBER - Print your Legacy Treasury Direct Account Number.
ACCOUNT NAME - Print the name(s) under which the account is registered.
CUSIP - You may use this form to either reinvest one bill or one note. Print the CUSIP number (e.g., 912795XXX) for the
reinvestment you are scheduling, canceling, or changing.
2. SCHEDULING
Investor Tip: All reinvestments must follow minimum/multiple/maximum holding requirements.

Minimums

Multiples

Maximums*

Bills

$100

$100

$5,000,000

Notes

$100

$100

$5,000,000

* Noncompetitive bids from a single bidder for the same offering may not exceed the maximum.

Select either the BILL REINVESTMENT column or the NOTE REINVESTMENT column.
BILL REINVESTMENT Instructions
• Check Box A to schedule an amount for reinvestment without specifying sub-accounts. Print the par AMOUNT you
want to reinvest. Check one box to select a reinvestment TERM of 13, 26, or 52 weeks. Print the number of TIMES you would
like to reinvest for the 13, 26, or 52 week term. (The maximum number of reinvestments for the 13, 26, and 52 week terms are
shown on the front of the form.)
• Check Box B to schedule or modify previously scheduled reinvestments for specific sub-accounts. Print the SUBACCOUNT number followed by the AMOUNT of that sub-account to be reinvested, the TERM (13, 26, or 52 weeks), and the
NUMBER OF REINVESTMENTS you are requesting for the 13, 26, and 52 week term. (The maximum number of reinvestments
for the 13, 26, and 52 week terms are shown on the front of the form.)
NOTE REINVESTMENT Instructions - Please read the SPECIAL NOTICE on the front of the form.
• Check Box A to schedule an amount for reinvestment without specifying sub-accounts. Print the par AMOUNT
you want to reinvest. Indicate the TERM of the reinvestment.
• Check Box B to schedule or modify previously scheduled reinvestments for specific sub-accounts. Print the SUBACCOUNT number followed by the AMOUNT of that sub-account to be reinvested and the TERM of the reinvestment.

3. CANCELING
• Check Box A to cancel all currently scheduled reinvestments for the CUSIP described in section 1.
• Check Box B to cancel all currently scheduled reinvestments for specific sub-accounts. Print the numbers of the SUBACCOUNTS for which reinvestments should be canceled.

4. AUTHORIZATION
Sign and date the request form. Reinvestment requests in the name of two individuals may generally be signed by either.
Please provide the telephone number (including area code) where you may be contacted if there are questions about this transaction.

SUBMISSION
Completed forms should be submitted to your Treasury Retail Securities Site office. You can find the Treasury Retail Securities Site
address on your Statement of Account or on the web (www.treasurydirect.gov). This form should be received at least 10
business days in advance of the maturity date of the loan (CUSIP) designated to ensure processing.
CONTACT
Call us toll-free in the United States at 1-800-722-2678. Outside the U.S.? Call us at (304) 480-6464.
CONFIRMATION
You will receive a Legacy Treasury Direct® Confirmation Notice showing any change in the security (par) amount or number of
scheduled reinvestments after your reinvestment instructions have been processed. Remember: The new security will not have
the same price and rate of return as the matured security.

FINE PRINT FOR TREASURY BILLS AND NOTES
The Treasury Department follows a pattern of securities offerings. However, the Secretary of the Treasury reserves the right to modify the terms and conditions of new
securities, and to depart from the customary pattern of securities offerings at any time. Consult the official offering announcement for the exact terms and conditions which
apply to the sale of the new security which you request. If the maturity date of this security does not coincide with the issue date of the new security, the amount of the
maturing security will be placed in a non-interest bearing account for a period not to exceed five (5) days.
YOU MAY NOT request noncompetitive reinvestment into any term of security where you are also bidding competitively through a commercial submitter or bidder in the
same auction. There are several additional restrictions applicable to noncompetitive bidders that are provided in paragraph 356.12 (b)(2) of Treasury Circular No. 1-93
(31 CFR Part 356).
REMEMBER, Treasury bills are sold by auction. The price is determined after the auction. As a noncompetitive bidder, your price is equivalent to the highest discount rate
at which bids were accepted.
REMEMBER, Treasury notes are sold by auction. The price is determined after the auction. As a noncompetitive bidder, your price is equivalent to the highest yield at
which bids were accepted. You may be required to PAY accrued interest if the security pays interest income for a period prior to the issue date. You may also be required
to pay a premium if the security is sold for a price above par. You will receive a notice and explanation of any monies due as a result of reinvestment.

NOTICE UNDER THE PRIVACY AND PAPERWORK REDUCTION ACTS
The collection of the information you are requested to provide on this form is authorized by 31 U.S.C. Ch. 31 relating to the public debt of the United States.
The purpose of requesting the information is to enable the Bureau of the Public Debt and its agents to issue securities, process transactions, make payments, identify
owners and their accounts, and provide reports to the Internal Revenue Service. Furnishing the information is voluntary; however, without the information Public Debt may
be unable to process transactions.
Information concerning securities holdings and transactions is considered confidential under Treasury regulations (31 CFR, Part 323) and the Privacy Act. This information may be disclosed to a law enforcement agency for investigation purposes; courts and counsel for litigation purposes; others entitled to distribution or payment; agents
and contractors to administer the public debt; agencies or entities for debt collection or to obtain current addresses for payment; agencies through approved computer
matches; Congressional offices in response to an inquiry by the individual to whom the record pertains; as otherwise authorized by law or regulation.
We estimate it will take you about 10 minutes to complete this form. However, you are not required to provide information requested unless a valid OMB control number is
displayed on the form. Any comments or suggestions regarding this form should be sent to the Bureau of the Public Debt, Forms Management Officer, Parkersburg, WV
26106-1328. DO NOT SEND completed form to the above address; instead, submit completed form to your Treasury Retail Securities Site.